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Superior mesenteric artery thrombosis after abrupt discontinuation of rivaroxaban

Christopher B Adams1, Nicole M Acquisto2, Jason M Rotoli3

  • 1Department of Pharmacy Services, University of California Davis Medical Center, Sacramento, CA 95817.

The American Journal of Emergency Medicine
|October 7, 2015
PubMed

We report a case of superior mesenteric artery thrombosis after the abrupt discontinuation of rivaroxaban in a 59-year-old male patient. The initial presentation was of sudden onset abdominal pain, nausea, vomiting, diarrhea, and hematochezia in the setting of recently holding rivaroxaban anticoagulation for an atrial flutter ablative procedure. Imaging revealed thrombosis of the superior mesenteric artery and acute mesenteric ischemia requiring emergent surgical intervention for embolectomy. Upon exploratory laparotomy, the bowel was found to be viable, and an embolectomy with patch angioplasty was successful without complication. This case illustrates the need for emergency medicine clinician familiarity with this possible medication adverse event with rivaroxaban.

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